Long-Term Disability Insurance FAQs

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General

Do I really need disability insurance?

If you need your income to pay for housing, food and other expenses, and have no other means to support yourself if an illness or injury kept you out of work (and without a paycheck) for over 90 days, you are a good candidate for disability insurance. Learn more here.

When is the right time to purchase disability insurance?

If you need it, then right now! It will never be cheaper for you than it is right now because the cost increases with age. If you’re in good health, you should easily qualify for a policy – and can lock in better rates at this age. However, if your health declines, you may no longer be insurable at an affordable premium

How much coverage should I have?

You should have enough to cover your living expenses (rent/mortgage, groceries, utilities, etc.). Generally, you should replace your monthly take-home pay. You may be able to trim your budget but be aware that you may have additional expenses while you’re ill or injured that may not be covered by your health insurance (for example – travel to see medical specialists)

I have group disability insurance through my employer so do I also need an individual disability insurance policy?

Maybe not – you should check the amount of coverage you have and the terms of your policy. But you might still consider purchasing an individual disability insurance policy for a number of reasons:

If you switch jobs, you probably won’t be able to take your LTD coverage with you. Depending on your age and health at that point, it could be difficult to obtain new LTD insurance if your new employer doesn’t offer it or you plan on being self-employed

Your coverage through work might not be enough. If your employer pays the premium, then any benefits you receive are taxed. This could leave you with an income “gap” if you’re out of work with a long-term injury or illness. For example, your group policy might cover 60% of your income, but taxes would effectively reduce that by 20-30%. There are supplemental disability policies you can purchase to close that income gap.

Many group policies have caps on coverage, so employees with higher salaries could be under-insured. Again, there are supplemental disability policies you can purchase to close that income gap.

Policy Features

What benefit amount should I get?

The benefit amount is based on a percentage of your current income. Typically this will be in the 60% range of gross (pre-tax) monthly salary. But remember that if you buy your own policy (with after tax dollars), your benefits will not be taxed. So a 60% coverage benefit could be pretty close to your current monthly take-home pay.

What is the elimination (waiting) period?

It’s the amount of time you have to wait from the first day you get ill or injured to when you start receiving benefits. Disability policies can carry elimination periods of 30, 60, 90, 180 or 365 days. Generally, the longer the elimination period, the lower your premiums will be. But keep in mind a few important things:

Most policies are designed to be most cost-effective with at least a 90-day waiting period.

Individual LTD policies usually pay at the end of each month – so if you have a 90-day elimination period, you will not receive your first claim check until the 120th day.

You should look at your financial situation to determine how long you can be without an income to decide what elimination period is best for you.

What is the benefit period?

It’s the length of time for which you’re eligible to receive monthly benefits while you have an illness or injury that keeps you out of work. Policies commonly pay for 2, 5 or 10 years or even to retirement age. The longer the benefit period, the higher the cost will be. A 5-year benefit period would cover the average duration of long-term disabilities across age groups (see the chart below). But depending on your age and health, a policy that covers you to age 65 (i.e., pays for a permanent disability) and gives you extra peace of mind might not cost that much more.

Check out our calculator to determine the odds of getting a disability as well as the likely length.

What features should I have on my disability policy?

We’ve recommended below key features a good-value disability policy should have. These recommendations are based on our extensive research and lean toward more comprehensive coverage so you’re covered when you need it most. See here for our full explainer on recommend features.

Good-value disability policies should always have:

“Own occupation” definition: How a disability is defined in relation to your occupation is one of the most important features of a disability policy. An “own occupation” policy defines a disability as the inability to work at your regular occupation, even if you still might be able to work at another occupation. For example, a surgeon with hand tremors who takes a job as a medical school lecturer would be eligible for LTD benefits under an “own occupation” policy because he can’t perform the duties of his own occupation (surgery).

The other option is an “any occupation” policy – to qualify as disabled under this policy, you must be unable to work at any occupation. This is a harder policy for claiming benefits, but it’s also usually less expensive than an “own occupation” policy. Bottom line - if you can afford the added cost of an “own occupation” policy, that’s probably what you want to get.

Non-cancelable coverage: This feature is a rate guarantee and ensures the carrier can never raise rates on the policy or cancel it (unless you stop paying premiums). This is particularly important for younger buyers who want to lock in a low rate until retirement

Residual benefits: Under a residual benefits disability provision (either in the policy or available by rider), you’ll receive partial benefits if your illness or injury has reduced your income but you’re still able to work (for example, if you’re only able to work part-time hours, a residual benefit will make up for the income loss).

Other features to consider:

Cost of Living Adjustment (COLA): Individual disability income policies generally offer a cost of living rider that will increase benefits for inflation during a long-term claim

Future increase option: As long as your increased income qualifies for more coverage under the company’s issue limits, the future increase option guarantees your right to purchase additional coverage up to a stated age without having to undergo medical underwriting again. This is a good idea if you’re a younger buyer and foresee salary growth in your future that you’d want to protect

Guaranteed renewable option: This renewability feature is a notch below the non-cancelable feature we discussed above. “Guaranteed renewable” means an insurer can never change or cancel a policy as long as you keep paying the premiums. However, it does not have a rate guarantee.
Unemployment waiver of premium:With this rider, if you were to lose your job, the premium on your disability policy would be waived – meaning you could keep your policy in force even if you can’t afford to pay the premium while temporarily unemployed

Catastrophic disability benefit:If you experience a disability that results in: 1) your inability to carry out two or more activities of daily living (e.g., bathing and dressing yourself), 2) cognitive impairment, or 3) total and permanent loss of sight in both eyes, hearing in both ears, or other specified disabilities, this additional rider may cover up to 100% of your previous income from all sources

Does my benefit coordinate with government benefits (such as Workers Compensation or Social Security)?

It depends on the policy. Some disability policies pay out the full benefit regardless of whether you qualify for Workers Compensation or Social Security Disability. Other policies will require you to apply for government benefits for which you might be eligible and will offset the benefit payment by the amount you receive from government aid.

Carrier Selection

Are insurance companies rated for quality?

There are various rating agencies that are independent and assign ratings to insurance companies based on an in-depth study of their operations and financial stability. Some of the more widely known agencies are A.M. Best, Standard & Poor’s, Fitch and Moody’s. The rating is typically assigned in the form of letters, e.g., AAA or A+. Each company’s website will have a link to its ratings from these agencies. You can also check out the PolicyGenius Insurer Report Cards, which has ratings and other information you might find useful in evaluating them. Financially sound companies are an important factor in deciding the company with which you chose to do business. See our reviews of some of the major disability insurers here.

Where can I find out which insurers are better at paying claims?

This is a difficult area to compare insurers on an “apples-to-apples” basis, since it depends on each insurer’s pool of customers, underwriting criteria, claims experience and other factors. We recommend checking with your state’s department of insurance for the complaint record of a particular company you are considering. In addition, you can search the National Association of Insurance Commissioners website for complaint records against specific insurers You can also check out the PolicyGenius Insurer Report Cards, which has claims information and other information you might find useful in evaluating them.

How do I compare policies from different companies?

Every policy is different which makes it very difficult to compare them side by side. The most important thing is to look for and understand important terms. Read the policy language and definitions carefully, as they vary greatly from company to company (e.g., what is the definition of “Own Occupation”; how do they value residual disability benefits?

Also, make sure you consult with an advisor you trust. At PolicyGenius all the policies we recommend have been pre-screened and translated so our clients are clear in terms of what is covered and what isn’t.

Application & Claims

How much will disability coverage cost?

You should expect to pay between 1-3% of your annual salary (women can expect a slightly higher range of 2-4%). These percentages are a rough estimate, based on selection of certain benefits and options. Most important is that your advisor understands your unique situation and ensures that the disability policy recommendation takes that into account. At PolicyGenius we pride ourselves on our customer care and always ensure you have the best options to choose from and feel confident that you have the most comprehensive coverage for your situation. See here for our full explainer page on long-term disability insurance costs.

How long will it take to get a policy issued?

The length of time for the issue of a policy will vary depending on the number and nature of additional requirements for that particular case. Companies may wish to acquire medical records for previous medical issues and sometimes this process can take many weeks. Generally, you can expect a disability policy to be issued within 4 to 6 weeks. At PolicyGenius we provide you with the required paperwork and a clear step-by-step guide to purchasing an LTD policy to ensure there are no delays in your application and you get covered as soon as possible.

Should I purchase disability insurance through my association?

You should definitely look at coverage through your association – which is often less expensive than buying on your own because the insurer is offering a group rate. However, you should compare the coverage offered by your association with individual policies offered by reputable disability insurance carriers. Then, select the policy that offers the best coverage for your situation. At PolicyGenius we can help you compare association coverage with individual policies to help you make the right decision.

If I use PolicyGenius to apply for LTD insurance will my personal information be safe and confidential?

At PolicyGenius we appreciate the sensitive nature of the financial, medical and occupational information required for a disability insurance application. We comply with all privacy and consumer protection laws and employ the strictest safeguards for your information.

Will I need to take a medical exam?
For an individual disability policy, you will probably have to submit some medical information as part of the underwriting process. Depending on your health history, your age and the amount of insurance applied for, you may also be required to take a paramedical exam. This exam is paid for by the insurance company and scheduled at your convenience. Usually, the exam involves basic measurements (of height, weight, pulse and blood pressure) and may also require blood and urine samples for analysis.

If tests or exams are required, who will pay for them?

The insurance company to which you’re applying for a policy will pay the entire cost and arrange for any tests to be done.

What if I have a health problem?

In some cases, coverage may still be issued. However, depending on the health issue, the coverage may be modified or a particular condition excluded from coverage, or an extra premium may be charged because of adverse health history

If I am issued a modified policy, can it be reviewed later?

In some instances, yes, depending on your health history. Regardless of any exclusions, we recommend having coverage for any other potential disabilities

Why do I have to provide proof of income?

Just as banks require income verification for mortgages and other loans, insurers will need to verify your income for disability insurance, which makes sense because coverage is tied to your income and the insurer is taking on the risk of paying that income should you become disabled. Usually, you’ll need to submit proof of income through tax returns, W2s and/or pay stubs

What exclusions are in my policy?

Exclusions in disability policies are those situations or events under which the policy will not pay a claim. Policy exclusions are usually few in number. Most often the exclusions apply to disabilities arising as a result of a crime, self-inflicted injuries, war or military action. Be sure to check any insurance proposal for these exclusions so you are fully informed as to what is not covered. At PolicyGenius all our quotes clearly highlight policy exclusions

Do I have to pay more if I purchase a disability policy through a broker?

No. Prices for disability policies are fixed by law and filed with state regulators. That means buying a policy through an independent broker will not cost you more than if you purchased directly from the insurer. An independent broker, such as PolicyGenius, will be able to give you recommendations from a number of carriers so that you can compare policies, features and price and make an informed decision

When does my disability policy go into effect?

Assuming you are approved by underwriting, your policy will be delivered to you. It goes into effect upon receipt and after you’ve paid the first premium payment.

After I buy, what are the reasons my premium can go up?

As you get older, if don’t have a non-cancelable policy your premiums can increase. This is because risk of a disability increases with age and thus the cost to insure you increases. We advise younger purchasers of disability to get a non-cancelable policy to “lock in” their rate. If you have a future increase option on your policy, you will be able to purchase more coverage when your income increases. But this increased coverage will come with a higher premium since you’re now insuring for a higher benefit payout.

If you do not have a non-cancelable policy, then insurance companies in some instances may increase the premiums for all their members. This is due to the change in the underlying risk of the insured group, which has resulted in higher payouts than premiums they are taking in. But raising rates requires regulatory approval (meaning the insurer can’t do this arbitrarily or on a specific person). Hee here for a full explainer on how long-term disability insurance works.

How difficult is it to make a disability claim?

Insurance companies will require you to provide proof of your disability, typically by filling out a claims form and submitting a statement from your doctor and copies of any relevant medical tests. Depending on the insurer and the type of claim, the claims process may be quite involved and take anywhere from a couple weeks to a few months. For major or more complex claims, there are disability attorneys and claims consultants who can advise and guide through the claims process (for a fee). At PolicyGenius, we’ve researched the claims practices of different insurers to recommend only those that we believe have a reputation for a fair claims process.

What happens if I'm laid off or change my job?

If you have bought an individual long-term disability policy this will be portable and you can take it to your next employer. With some individual policies you can also purchase an unemployment waiver of premium that will cover your premiums for a defined period of time while you’re unemployed.

If you own a group long-term disability policy this is probably not portable. So you would need to apply for a new policy either at your next employer or individually, if your new employer does not offer a group plan.

Can’t I just file a claim for Social Security Disability Insurance (SSDI) benefits if I’m unable to work because of injury or illness?

If you have a long-term disability you can (and should) apply for SSDI benefits. But be prepared for a lengthy and difficult process. To qualify for SSDI, you have to be unable to do any occupation (not just the occupation you had before your disability that you may have specially trained or were educated for) and have been totally disabled for at least 5 months. Also be aware that nearly 65% of initial SSDI claims applications are denied. And, if you successfully appeal the denial, it could take up to 2 years to start receiving benefits. If approved, the average monthly benefit paid by SSDI is around $1,000 a month. Consider whether you could wait that long and live on that amount if you had a long-term injury or illness that kept you out of work. See our full explainer page on why Social Security Disability Insurance may not be enough protection.

Yes, we have to include some legalese down here. Read it larger on our legal page. Policygenius Inc. (“Policygenius”) is a licensed independent insurance broker. Policygenius does not underwrite any insurance policy described on this website. The information provided on this site has been developed by Policygenius for general informational and educational purposes. We do our best efforts to ensure that this information is up-to-date and accurate. Any insurance policy premium quotes or ranges displayed are non-binding. The final insurance policy premium for any policy is determined by the underwriting insurance company following application. Savings are estimated by comparing the highest and lowest price for a shopper in a given health class. For example: for a 30-year old non-smoker male in South Carolina with excellent health and a preferred plus health class, comparing quotes for a $500,000, 20-year term life policy, the price difference between the lowest and highest quotes is 60%. For that same shopper in New York, the price difference is 40%. Rates are subject to change and are valid as of 2/17/17.